Should All Midwives Be Licensed?

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Pete Springer/OPB

About once a year on Think Out Loud we dive into a conversation about midwifery. In 2009 we explored the “pattern of distrust” between midwives and physicians. Last summer we asked whether a woman should be able to use a midwife if she previously had a Caesarean section or was expecting twins or a breech baby. This year the conversation focuses on whether it should be mandatory for midwives to be licensed.

The issue of licensing gained prominence recently when a woman in Eugene used two unlicensed midwives to deliver her baby. The baby was born without a heartbeat and did not survive. She claims the midwives refused to send her to a hospital when they encountered problems. Some people say this is exactly the kind of crisis that would be avoided if all midwives were licensed. Other people argue that the government has no business deciding how a birth can or cannot happen. They also say that there will always be midwives who are unwilling to be licensed and that there will be far greater problems if they (and their clients) go “underground.”

Half of the estimated 150 midwives in Oregon are licensed, an apprenticeship process that requires attending 45 births while under supervision, completing 40 hours of specialized training and passing a variety of exams. About 1,000 home births per year occur in Oregon.

All of this debate is leading some midwives with licenses to drop them in support of their unlicensed colleagues. And it’s making others who have traditionally been against licensing to change their minds.

Are you a midwife? Do you think your professional practice should require licensing? Why or why not?

Have you had your baby at home? Why did you choose a licensed — or unlicensed — midwife? What do you think should happen?